Amy Winehouse and Adele Contrast/ Comparison

Amy Winehouse and Adele are the two Englishwomen that have dominated   the UK music industry in the past few years and their impact on the global scene has made them equally memorable and inspiring. They stamped British music forever through their vintage looks but more so through their powerful voices and distinct genres. Winehouse and Adele are both white girls who owe a debt to black soul music.The distinction between them is emphasized more so through their best works, the albums ( Winehouse's † Back to Black† and Adele's † 19†³) that forever transitioned them from London's Brit art school performers(where they were alumni)to successful artists. Without a doubt, the albums these artists created are considered great achievements of our era and the most complex masterpieces of our time. They reflect these ladies' heartbreak due to failed relationships through a mesmerizing but rich sound topped by a distinct musical and lyrical style.Adele's album is simple and clean, less menacing whereas Amy's is a little slight more edgy and memorable. The album â€Å"19† encompasses a bright acoustic-guitar chime, with a lullaby twinkle of plush strings and Adele's mesmerizing  singing tone, honest lyrics, jazz and soul influences evokes Amy's. Adele's delivery is accomplished through a more delicate bluesy tone whereas Amy's is represented by a brick house jazzy expressiveness far beyond our time. Adele is simpler lyrically and occasionally even soppy and somehow redundant lyrically, she doesn't have the mature poetic heritage that Amy does.Talented writers and composers these two muses beautifully show through their lyrics a deep attachment to the lost love and the disappointments that follow its course. â€Å"Back to Black† sounds emotionally and musically true. All eleven songs seem like great lost classics from the 60s : â€Å"Rehab†Ã‚  has many shades of Motown and contemporary twists, â€Å"Me and Mr. Jones† be longs to the swing era of the 60s and   Ã¢â‚¬Å"Loving Is A Losing Game† is a stunning soul ballad with a vintage finish.Winehouse's songs are snappily written with a mix of bitterly caustic lyrics and finger popping tunes, then delivered in a voice that alternates sexy smouldering with dismissive contempt. In the song  Ã¢â‚¬Å"You know I'm No Good†, she's unapologetic about her unfaithfulness but she can also be witty, as on â€Å"Me & Mrs Jones† when she berates a boyfriend with â€Å"You made me miss the Slick Rick gig†. Some will find Adele rigidly old-fashioned with influences (Etta James, Billie Holiday) from another age and her album truly shows that forgotten era.Amy's   influence of girl groups from the 50s   and early 60s is plain: plinky keyboards, parpy brass, trebly guitar. A cursory listen to† 19†³may lead us to conclude that Adele has not just a voice but an appearance way in excess of her years. The same can be said about Wi nehouse except she's   more daring not just appearance wise but vocally and   lyrically as well and through her writings she evokes more depth. The music poures out of Amy a stream of weathered, seasoned phrases, seemingly without effort and â€Å"Back to Black†, is a more soulful and stripped album than Adele's.Strong one moment then fragile the next, † 19†³   is an album that is dominated by highlights dripping with beauty and class. On the other hand   Ã¢â‚¬Å"Back to Black† is flawless and classic and represents the artist's true masterpiece. It's not that â€Å"Back to Black† is better as an overall album but besides being a door opener for many artists its appearance  on the British scene was necessary so we can have Adele's â€Å"19†. British singer Adele has credited Winehouse's success in the USA and more so for making her journey smoother. Winehouse reacquainted an audience with a long forgotten genre by overcoming the vintage aspect.After the release of â€Å"Back to Black†, record companies sought out artists with a similar sound but also fearless and experimental female musicians. Winehouse revitalized   British music forever and influenced British female artists like Adele, Duffy, Emeli   Sande, Misha B. , Jessie J. , Paloma Faith and Florence Welch. These musicians can all be traced back to Winehouse in terms of attitude, musical styles and fashion. Adele's voice caresses and inspires and she sings with unabashed passion about a kind of pain we can all recognize.Amy's voice on the other side is full of soul and characterized by a sultry sound and she delivers amazingly strong and timeless performances that once heard can never be forgotten. Songs like † Me and Mr. Jones† and â€Å"Tears Dry On Their Own† really show her capability to seamlessly go from soul to jazz and back to soul all the while evoking that spirit that is essential in emphasizing her sophisticated and thrilling musical style. Different as they seem – in the way they evolved musically and vocally- these two divas have much in common.Under everything else they both achieved success at an early age through their mutual passion for music and their indisputable talent. Their originality and soulful mannerism is clearly evoked in their albums. Amy and Adele didn't just pave the road for new British artists but have beautifully   reinstated   love as a main theme of our musical era through their deep songs. Two Grammy winners, with retro contemporary sounds they had forever changed people's   outlook on music and will remain the most acclaimed musical game changers of our century. Amy Winehouse and Adele Contrast/ Comparison Amy Winehouse and Adele are the two Englishwomen that have dominated   the UK music industry in the past few years and their impact on the global scene has made them equally memorable and inspiring. They stamped British music forever through their vintage looks but more so through their powerful voices and distinct genres. Winehouse and Adele are both white girls who owe a debt to black soul music.The distinction between them is emphasized more so through their best works, the albums ( Winehouse's † Back to Black† and Adele's † 19†³) that forever transitioned them from London's Brit art school performers(where they were alumni)to successful artists. Without a doubt, the albums these artists created are considered great achievements of our era and the most complex masterpieces of our time. They reflect these ladies' heartbreak due to failed relationships through a mesmerizing but rich sound topped by a distinct musical and lyrical style.Adele's album is simple and clean, less menacing whereas Amy's is a little slight more edgy and memorable. The album â€Å"19† encompasses a bright acoustic-guitar chime, with a lullaby twinkle of plush strings and Adele's mesmerizing  singing tone, honest lyrics, jazz and soul influences evokes Amy's. Adele's delivery is accomplished through a more delicate bluesy tone whereas Amy's is represented by a brick house jazzy expressiveness far beyond our time. Adele is simpler lyrically and occasionally even soppy and somehow redundant lyrically, she doesn't have the mature poetic heritage that Amy does.Talented writers and composers these two muses beautifully show through their lyrics a deep attachment to the lost love and the disappointments that follow its course. â€Å"Back to Black† sounds emotionally and musically true. All eleven songs seem like great lost classics from the 60s : â€Å"Rehab†Ã‚  has many shades of Motown and contemporary twists, â€Å"Me and Mr. Jones† be longs to the swing era of the 60s and   Ã¢â‚¬Å"Loving Is A Losing Game† is a stunning soul ballad with a vintage finish.Winehouse's songs are snappily written with a mix of bitterly caustic lyrics and finger popping tunes, then delivered in a voice that alternates sexy smouldering with dismissive contempt. In the song  Ã¢â‚¬Å"You know I'm No Good†, she's unapologetic about her unfaithfulness but she can also be witty, as on â€Å"Me & Mrs Jones† when she berates a boyfriend with â€Å"You made me miss the Slick Rick gig†. Some will find Adele rigidly old-fashioned with influences (Etta James, Billie Holiday) from another age and her album truly shows that forgotten era.Amy's   influence of girl groups from the 50s   and early 60s is plain: plinky keyboards, parpy brass, trebly guitar. A cursory listen to† 19†³may lead us to conclude that Adele has not just a voice but an appearance way in excess of her years. The same can be said about Wi nehouse except she's   more daring not just appearance wise but vocally and   lyrically as well and through her writings she evokes more depth. The music poures out of Amy a stream of weathered, seasoned phrases, seemingly without effort and â€Å"Back to Black†, is a more soulful and stripped album than Adele's.Strong one moment then fragile the next, † 19†³   is an album that is dominated by highlights dripping with beauty and class. On the other hand   Ã¢â‚¬Å"Back to Black† is flawless and classic and represents the artist's true masterpiece. It's not that â€Å"Back to Black† is better as an overall album but besides being a door opener for many artists its appearance  on the British scene was necessary so we can have Adele's â€Å"19†. British singer Adele has credited Winehouse's success in the USA and more so for making her journey smoother. Winehouse reacquainted an audience with a long forgotten genre by overcoming the vintage aspect.After the release of â€Å"Back to Black†, record companies sought out artists with a similar sound but also fearless and experimental female musicians. Winehouse revitalized   British music forever and influenced British female artists like Adele, Duffy, Emeli   Sande, Misha B. , Jessie J. , Paloma Faith and Florence Welch. These musicians can all be traced back to Winehouse in terms of attitude, musical styles and fashion. Adele's voice caresses and inspires and she sings with unabashed passion about a kind of pain we can all recognize.Amy's voice on the other side is full of soul and characterized by a sultry sound and she delivers amazingly strong and timeless performances that once heard can never be forgotten. Songs like † Me and Mr. Jones† and â€Å"Tears Dry On Their Own† really show her capability to seamlessly go from soul to jazz and back to soul all the while evoking that spirit that is essential in emphasizing her sophisticated and thrilling musical style. Different as they seem – in the way they evolved musically and vocally- these two divas have much in common.Under everything else they both achieved success at an early age through their mutual passion for music and their indisputable talent. Their originality and soulful mannerism is clearly evoked in their albums. Amy and Adele didn't just pave the road for new British artists but have beautifully   reinstated   love as a main theme of our musical era through their deep songs. Two Grammy winners, with retro contemporary sounds they had forever changed people's   outlook on music and will remain the most acclaimed musical game changers of our century.

“Sometimes You Have to Pick the Gun Up to Put the Gun Down” Essey

â€Å"Sometimes you have to pick the gun up to put the gun down.† This quote was said by Malcolm X, who was an African American Minister and a human rights activist. It means that sometimes you have to fight in order to achieve peace. I agree with what he said because in order to get what you want you have to fight for it.Two literary works that reflect this quote are Fences, a play about the struggles of African American before and during the Civil Rights Era in the 1950s and 60s, by August Wilson and â€Å"The Yellow Wallpaper† a short story that shows the difference between women and men during that time, by Charlotte Perkins Gilman. ‘Fences’ shows the revolution the characters face, their actions and what is the result of those choices. Whereas, ‘The Yellow Wallpaper’ is about how the wife struggles to speak against her husband.She shows revolution when her husband tells her not to write but she secretly writes in her journal. Both literary pieces, Fences, by Wilson and The Yellow Wallpaper by Perkins Gilman, shows how the lack of communication, the lack of acknowledgment and the demand for changes shows how the characters fight for what they want.The play Fences is set in Pittsburgh, Pennsylvania in the 1950 and ‘60s by August Wilson. August Wilson was named Frederick August Kittel when he was born to a German father and an African American mother in 1945. When Wilson was sixteen, he was accused of plagiarism at school when he wrote a sophisticated paper that the administration didn’t believe he could write.The principal suspended him and later ignored his attempts to come back to school. Wilson soon dropped out of school and educated himself at the local library. Wilson got involved himself in the black power movement while he worked on his poetry and short stories.The characters Wilson includes in his play Fences are Troy,the main character, where he struggles to carry his family; Rose,Troy’s wi fe who is a typical 1950s house wife; Cory, who is the son of Troy and Rose, wants to be like Troy in the beginning, but fights with Troy for he tries to take his dream of a football career from him.The short story â€Å"The Yellow Wallpaper† is set in the 19th century in America by Charlotte Perkins Gilman. Charlotte Perkins Gilman was born on July 4, 1860, in Hartford, Connecticut. At the age of five Gilman taught herself how to read, because her mother was sick. In 1884 she married an artist Charles Walter Stetson.Their only child Katherine Beecher Stetson, was born the  following year. Gilman suffered a postpartum depression in the months after Katharine's birth. After her mother died she decided to move back east, where she met her cousin Houghton Gilman, who she had not seen in fifteen years. She married Houghton and moved to Norwich, Connecticut. After Houghton died,with cerebral hemorrhage in 1934, she moved back to Pasadena, California. In January 1932, Gilman was diagnosed with incurable breast cancer. Gilman committed suicide on August 17, 1935 by taking an overdose of chloroform.In the play Fences, ‘the lack of communication’ between Troy and Cory shows revolution. Cory is scared of Troy so he could not talk to him. Troy is always bossing around Cory, so Cory feels distance towards his dad. â€Å"All you ever did was try and make me scared of you . I used to tremble every time you called my name. Every time I heard your footsteps in the house.Wondering all the time†¦. what’s Papa gonna say if i do this?†¦. What’s he gonna say if I do that? †¦ What’s Papa gonna say if I turn on the radio?† (Wilson 86-87). This quote states that Cory was scared of Troy and could not speak to him, and thought about how his actions affect the way his father acts and speaks towards him.The literary techniques Wilson shows is repetition. Repetition is a way that the writer conveys how important Cory’ s feelings are and how concerned someone is. The repetition of the words â€Å"What’s pappa gonna say† shows how Cory is too concerned about the relationship between his dad and himself. The lack of communication between father and son cause Cory to revolt towards his dad.The lack of acknowledgment in the play Fences between Troy and Cory cause their relationship to decline even further. One of the greatest sources of disappointment in Troy's life is the fact that he wasn't allowed to play pro baseball, Even though he used to hit homeruns in the Negro Leagues, he couldn't go to the majors because of racial discrimination. He doesn't let Cory play football, because he doesn't want Cory to feel what he felt during his time.Troy’s lack of acknowledgment of Cory’s potential destroys Cory’s dream by not signing the papers and not letting the college recruiter from coming. â€Å"I got sense enough not to let my boy get hurt playing no sports†(Wils on 39) He unconsciously stats that he doesn't want Cory to feel  how he felt during his time. This quote references flashback because in this quote Troy refers back to what had happened to him during his athletic career, and how it affected his life.In this quote he speaks like a father who is making decisions for his son and his future, even though the people around him is telling him that the time has changed and it is not like before. Troy’s lack of acknowledgment causes Cory to lose his dream and late Cory to leave the house.

Global Prevalence Of Hypertension Health And Social Care Essay

High blood pressure is a major contributing factor for cardiovascular disease. WHO report ( 2002 ) showed that India may be the largest cardiovascular disease load in the universe by the twelvemonth 2020. WHO report in India 2005 stated that prevalence of high blood pressure was increased by approximately 30 times among urban community people and by approximately 10 times among the rural community people. Many causes might hold contributed to this lifting tendency such as lifestyle alteration, alteration in diet and stress, increased population and unemployment have been implicated. High blood pressure is a â€Å" ignored disease, † harmonizing to a study released by the Institute of Medicine ( IOM ) . Despite high blood force per unit area being the cause of decease in one of six grownups and the greatest individual hazard factor for decease from cardiovascular disease, 1000000s of people are developing, populating with, and deceasing from high blood pressure. The decennary from 1995 to 2005 saw a 25 % addition in the decease rate from high blood force per unit area, the study notes. The Institute of Medicine study besides highlighted the fiscal barriers to take downing blood force per unit area. Surveies have shown that the cost of medicines to patients is significantly related to patient attachment ; this is particularly apparent in patients with low income, chronic unwellness, and multiple prescriptions. Kalavathy et al. , ( 2000 ) High blood pressure is one of the major community wellness job in India. This one found from several Indian urban and rural studies. More surveies shows a prevalence rate of high blood pressure among urban population runing from 1 % in 1949 to 36 % in 2003 and for rural people from 1.97 % in 1958 to 20.2 % in 1994. Determining the degree of high blood pressure and besides differing age groups representing the survey population so the rates are different. Developed states with a more aging group will be expected to hold a higher prevalence of high blood pressure than a underdeveloped state with a younger group such as India, but some surveies, which have documented a high prevalence rate of high blood pressure in developing states. Few late conducted studies from Western India shows high prevalence of systolic high blood pressure at old age groups ( bulk in age group of 70 old ages ) , among Kerallite 51.8 % from South India and Assamese 63.63 % .Every twelvemonth about 5.3 hundred thousand Indians dice of high blood pressure related coronary disease. It has been found from in a survey Northen india that the incidence of high blood pressure increased from 3.98 % in 1963 to 26.78 % in 2000 among work forces while the incidence of high blood pressure increased from 6.67 % to 27.65 % among adult females. Systolic high blood pressure has been considered to be one of the most of import causes of morbidity and mortality taking to major diseases like shot, cardiovascular and nephritic diseases. Urban survey in India had shown a more per centum of population in the pre high blood pressure phase. Excess competition in academic field is one of the emphasis for the younger people in India and besides unemployment. Number of surveies have already explained that the relationship between Blood force per unit area and hazard of bosom diseases. Pre hypertensives have more opportunity to travel into phases of high blood pressure. Hence it is besides possible that the immature stressed people with prehypertensives degree of blood force per unit areas may be at hazard factor to develop bosom diseases. This survey accent on two demands such as sleep and command blood force per unit area. Adequate slumber is indispensable demands for human existences.The human being needs remainder & A ; slumber to conserve energy and good being, prevent weariness, supply organ to reprieve and alleviate tenseness. Sleep want consequence in a lessening in organic structure temperature, a lessening in immune system map. If sleep continues over a longer clip it increases the hazard of more serious wellness jobs such as weakened immune system, diabetes mellitus, depression, high blood force per unit area and fleshiness. There are place remedial steps to better slumber such as utilizing comfort devices, devouring warm milk, reading narrative book and by supplying good airing.Non pharmacological intercessions to take down blood force per unit areaThere is turning grounds that non pharmacological intercessions lower high blood force per unit area. These intercessions are non dearly-won and are by and large good in advancing good wellness. They besides help in cut downing the cardiovascular hazard factors with a small cost. ( Joyce M. Black ) Indian Medical Association 2001 study â€Å" In pull offing high blood pressure, antihypertensive drugs have of import function, but focal point may be directed towards some lifestyle alterations † . Dietary alteration, physical activities may act upon the minimize of Blood force per unit area. Body weight decrease, less alcohol consumption, limitation of salt and besides K, Ca supplementation can better the procedure of take downing Blood force per unit area. Fiber rich diet either and low Na could cut down the Blood force per unit area by about 5 millimeters Hg among high blood pressure clients. Other than this, behavioural alterations like halt smoke, regular exercisings, relaxation therapies like yoga, etc, have good consequence on high blood pressure clients. The consequence of lifestyle alterations may forestall a demand of drug direction for high blood pressure. For this all hypertensive clients should be tried ab initio one or more of the lifestyle alterations. Gupta 1997 recommends progressive relaxation, deep external respiration exercising and yoga may assist to cut down the blood force per unit area. TK Luqman -Arafath study 2002 shows that the mortality rate from both Ishemic bosom disease and stroke doubles while every 20 mmHg systolic or 10 mmHg diastolic rise in Blood force per unit area. In fact, even minimal decrease in Blood force per unit area among the general population could decidedly cut down cardiovascular events. For illustration, a 3 mmHg decrease in systolic Blood force per unit area would take to an 8 % decrease in stroke mortality rate and a 5 % decrease in mortality rate due to coronary arteria disease. There has been increasing of import gives to the preventative steps like regular exercisings, express joying combined with speculation, less ingestion of intoxicant, cut down the consumption of Na and the Dietary alterations to take down the Hypertension rate. Many literatures reveal that laughter therapy helps in cut downing the blood force per unit area. Laughter promises a utile attack to intervention of high blood pressure. Systematic instruction of laughter therapy exert a positive influence on a client with hypertensive reduces blood force per unit area.The Benefits of laughter therapyLaughter therapy is an first-class type of exercising.The laughter therapy has three types, in the first type, one laughs freely and aloud with unfastened oral cavity, in the 2nd type, one laughs without any sound with closed oral cavity and in the 3rd type, one pours out loud effusions of laughter through the pharynx like neighing of Equus caballus. A figure of research surveies reveals that laughter has many wellness benefits. During the thirteenth century Surgeons used wit to deflect patients from hurting entirely. Later, in the twentieth century, came the scientific survey of the consequence of laughter on overall wellness. Harmonizing to Kay Herth ( 1984 ) laughter as a emphasis fellow. Laughter has a built in equilibrating mechanism that encourages two measure action of stimulation and relaxation due to let go of of chemicals adrenaline and nor epinephrine. This reduces anxiousness, tenseness and depression. Therefore, it helps in extenuating several serious diseases such as high blood pressure, bosom disease, diabetes, anxiousness, insomnia etc. Fry states that laughter is a good aerobic exercising. He says that 100 laugh a twenty-four hours is equal to 10 proceedingss rowing or jogging. Berk, Tan, Fry et Al ( 1997 ) reported drawn-out emphasis creates unhealthy physiological alterations and Stress causes the adrenal secretory organs to let go of corticoids and emphasis endocrine alterations during gay laughter. In a survey at Canada ‘s University of Waterloo documented that laughter additions degree of immunoglobulin IgG and IgM and concludes that laughter consequences in improved unsusceptibility. Cognetal ( diary of behavior medical specialty ( 1997 ) has reported the ability of laughter to let go of musculus tenseness and helps to let go of neuropeptides which are organic structure ‘s natural hurting stamp downing agents. Therefore, laughter has multi drawn-out attack for the alleviation of hurting, in painful conditions such as arthritis, spondylitis, etc. Lloyd ( 1990 ) showed that laughter is a combination of deep inspiration and full halitus animating first-class airing and fantastic remainder.Thus laughter additions lung capacity and oxygenation.This would profit patients with lung diseases such as bronchitis, bronchial asthma. The findings of Dr.Lee Berk and Dr.Stanle ( 1999 ) during their more than 10 old ages research on laughter addition the figure of ‘activated ‘ T cells and increases the degrees of gamma interferon, a lymphokine that activates many immune constituents.Need FOR THE STUDYCoronary events such as a â€Å" bosom onslaught † are still the most common consequence of high blood pressure. Increased blood force per unit area is related to increased badness of coronary artery disease, shot, neuropathy, peripheral vascular diseases, aortal aneurism, and bosom failure. About all people with bosom failure have antecedent high blood pressure. If high blood pressure is left untreated, about half of hypertensive clients will decease of bosom disease, a 3rd will decease of shot, and the staying 10 % to 15 % will decease of a nephritic failure. High blood pressure is besides a â€Å" soundless factor † in the etiology of many deceases attributed to stroke or bosom onslaughts. These upseting tendencies indicate the demand for renewed energy in the conflict against high blood pressure. Hypertension related morbidity and mortality will non diminish until suppliers appreciate the demand for alterations in bing intervention protocols.Now chiefly bar focused and strongly urge usage of non pharmaceutical steps to forestall and handle high blood pressure. ( Joyce m.black, 2001 ) Harmonizing to Indian Express Bureau ( 2004 ) one in every 10 Indian suffer from high blood force per unit area.Now a yearss antihypertensive drugs are available to command blood force per unit area.These drugs have their ain side effects and are expensive. Non conformity to medicine is really common among hypertensive patients due to assorted grounds. Antihypertensive medicines entirely can non command blood force per unit area, physiological relaxation is really of import for keeping blood force per unit area. The research worker observed that most of the hypertensive patients had unequal cognition about significance, hazard factors, marks and symptoms sing high blood pressure and its related complications. The hypertensive patients do non follow the non pharmacological steps like exercising, emphasis cut downing activities like yoga and turning away of diet which contains more cholesterin. These patterns are non adopted by bulk of the patients largely because of unknowingness and deficiency of accent by the wellness suppliers. Sushil Bhatia, the editor of Lorvani ( 2004 ) , province that express joying combined with speculation, harmonises all our sense organs in a minute of entire concentration and brings equilibrium to mind, organic structure and external respiration which are like three bases of a rope. Peoples utilizing this therapy experience dramatic alleviation from upsets such as depression, migrane and high blood pressure. American Journal of Medical Science reported that emphasis endocrine alterations during gay laughter. The research worker during her clinical exposure in the community has observed that many older people are enduring from high blood pressure. Some hypertensive people are taking medicines, some are non taking medicine on a regular basis. Those hypertensive patients do non follow the non pharmacological steps like exercising and speculation. Based on the information showed on prevalence of high blood pressure, research worker recognized the demand for learning laughter therapy to the hypertensive people in this selected rural community. Therefore this survey was undertaken to measure the consequence of laughter therapy on blood force per unit area and slumber among patients with high blood pressure.STATEMENT OF THE PROBLEMA survey to measure the consequence of laughter therapy on blood force per unit area and slumber among patients with high blood pressure in a selected rural community at Coimbatore.AIM OF THE STUDYThe chief purpose of the survey is to find whether laughter therapy mak es a important difference in blood force per unit area and slumber among hypertensive patients in comparing with the non receiving systems of laughter therapy.Specific OBJECTIVESThe specific aims of the survey are 1. To find the degree of blood force per unit area in the experimental and control group before and after laughter therapy. 2. To find quality of slumber reported by the sample in the experimental and control group before and after laughter therapy. 3. To find the association of blood force per unit area and slumber with demographic variables such as business, exercising and diet.HypothesisH1: There will be important difference in average systolic and diastolic blood force per unit area before and after intercession in experimental group. H2: There will be important difference in average systolic and diastolic blood force per unit area of the experimental and control group after intercession. H3: There will be important difference in average mark of slumber before and after intercession in experimental group. H4: There will be important difference in average sleep mark of the experimental and control group after intercession.OPERATIONAL DEFINITION1. Blood force per unit areaIt refers to the force per unit area of the blood within the arterias of the organic structure.When the ventricle of bosom contracts, blood is forced out into the aorta and travels through the largest arterias to the smallest arterias, arteriolas and capillaries. The pulsing extends from the bosom through the arterias and disappears in the arteriolas. The pulsing is measured by utilizing a sphygmomanometer and is expressed in millimeter of Hg.a ) Systolic blood force per unit areaIt is the maximal grade of force per unit area exerted by the blood against the wall of the blood vass during the ventricular contraction when the left ventricle is coercing the blood into the aorta. The first sound is called systolic blood force per unit area.B ) Diastolic blood force per unit areaThis is the lowest force per unit area that o ccurs when the bosom is in the resting period merely before the contraction of the left ventricle. The 2nd sound is called diastolic blood force per unit area.2. High blood pressureIt is defined as relentless lift of the systolic blood force per unit area and diastolic blood force per unit area from the normal degree. Normal blood force per unit area: 120/80 millimeter of Hg.3 STAGES OF HYPERTENSIONSystolic blood force per unit area Diastolic blood force per unit area Level of blood120 – 139mm of Hg. 80 – 89 millimeter of Hg pre high blood pressure 140 – 159 millimeter of Hg 90 – 99 millimeter of Hg phase I hypertension & gt ; 160 millimeter of Hg & gt ; 100 millimeter of Hg phase II high blood pressure3. SleepSleep is a province of remainder in which the nervous system is inactive, the eyes are closed, the musculuss are relaxed and the head is unconscious. The features of slumber can be verbalized by the individual who experiences the slumber. In this survey the self study of slumber is measured on a sleep graduated table.4. LAUGHTER THERAPYThe laughter therapy is an first-class type of exercising which control blood force per unit area by cut downing the release of emphasis related endocrines and brings about relaxation.Premise1. High blood pressure is more common among grownups than adolescent age group. 2. Blood force per unit area can be kept in control by medicine and lifestyle alteration. 3. Laughter could give alleviation from physical or mental emphasiss.Boundary line1. The survey is limited to one community. 2. The survey is delimited to patients within the age group of 40 to 60 old ages.Scope OF THE STUDYThe degrees of blood force per unit area and slumber are measured in hypertensive patients before and after intervention.If there is a important decrease in the blood force per unit area and positive result in the features of slumber of experimental group of sample, it is a clear effectivity of laughter therapy. Teaching laughter therapy is simple and it can be practiced easy. If the topics are able to execute this therapy without any trouble, this intercession is acceptable, it is clear indicant of the public-service corporation value of laughter therapy for hypertensive patients.The findings will be good to wellness patterns to actuate hypertensive patients and patients on antihypertensive drugs to command and keep their blood force per unit area at normal degree.CONCEPTUAL FRAMEWORKA conceptual theoretical account can be defined as a set of constructs and those premises that integrat e them into a meaningful constellation ( Fewett,1980 ) . The development of a construct was theoretical account is a cardinal procedure required before carry oning existent research.The model influences each province of research procedure. The conceptual model in nursing research can assist to supply a clear concise thought of cognition in the country. Conceptual frame work for this survey was a nursing procedure theoretical account based on Dorothy.E.Johnson ‘s behavioral system theory ( 1980 ) . Harmonizing to Johnson, nursing positions the person as a set of interrelated or mutualist parts working as an incorporate whole. Johnson identified seven subsystems. The subsystems are affliative, aggressive, dependence, eliminative, ingestive, renewing, and sexual. These subsystems carry out particular map for the system as a whole. Disturbance in any of the system normally affects the other. The stairss of the nursing procedure are incorporated with the Dorothy E. Johnson ‘s theoretical account. Nursing procedure is a deliberate activity where the pattern of nursing is performed in a systematic order. Johnson presents a three measure nursing procedure, the stairss are entitled nursing diagnosing which parallel the appraisal and diagnosing stage, the 2nd measure nursing end peers to the execution and 3rd measure is rating. This survey focused on kids and the dependence system which is one among the subsystems which result in blessing, attending, acknowledgment, and physical a id.AppraisalAppraisal is the procedure of roll uping informations sing each subsystem. Data on demographic profile ( age, instruction, business, income, nutrient and exercising wonts, history of antihypertensive medicines ) was collected.DiagnosisThrough appraisal from the subsystem jobs are identified and diagnosing is made and it provides footing for nursing intercession. In this survey the informations collected through observation of blood force per unit area and utilizing interview agenda. The diagnosing is made and categorized into prehypertension, phase I hypertension and stage II high blood pressure.Nursing endsAfter diagnosing is made the end is to keep or reconstruct the individual ‘s behaviour system balance, and stableness through planning intercessions. In this survey the end is to cut down blood force per unit area and to advance slumber.InterventionNursing activity is an external regulative force assists the individual to recover equilibrium. In this survey the nursing activity is to learn the laughter therapy techniques to the experimental group for a period of clip to convey alteration in the blood force per unit area and slumber.EvaluationEvaluation refers to look intoing the subsystem identified as debatable for balance and overall system stableness. In this survey the research worker compared the experimental group with the control group by utilizing the observation of blood force per unit area and self report quality of slumber given by sample. Figure -1 Highlights the conceptual model on modified nursing procedure based on Dorothy E. Johnson Behavioural System Model. Bellert, ( 1989 ) . Wit: A Curative Approach in Oncology Nursing. † Cancer Nursing,65-70. Brooks et.al. ( 1999 ) . Curative Humor.International Journal of Humor Research, 151-160. Buckwalter et.al. ( 1995 ) . The Humor and Individuality of Persons with high blood pressure. Journal of Gerontology Nursing,11-16. Erdman and Lynn. ( 1993 ) . Laughter Therapy for Patients with Cancer. Journal of Psychosocial Oncology, 55-67. Ferguson, Stephanie, et. Al. ( 1989 ) . Wit in Nursing. Journal of Psychosocial Nursing, 29-34. Galloway. ( 1999 ) . Benefits of Humor.International Journal of Humor Research, 301-314. Mallett and Jane. ( 1993 ) . Use of Humor and Laughter in Patient Care. † British Journal of Nursing,172-175. Matz and A. Brown ( 1998 ) , â€Å" Humor and Pain Management. † Journal of Holistic Nursing. : 68-75.ONLINE REFERENCEEnda junkins ( 2007 ) .The power of laughter retrieved from hypertext transfer protocol: //laughter therapy.webs.com. Gita Suraj Narayan ( 2009 ) .Laughter is a powerful signifier of complementary Medicinretrievedfrom hypertext transfer protocol: //www.medicalnewstoday.com/articles/146449.php Gasto, R.Lack of slumber linked to increased hazard of high blood pressure.Archives of geriatrics and geriatrics:30 ( 1 ) :7-15.Retrieved from hypertext transfer protocol: //www.medscape.com. John, tungsten ( 2004 ) .Non-pharmacological intercession of high blood pressure retrieved from hypertext transfer protocol: //www.science direct.com/science. Kazuo Murakami ( 2001 ) .Laughter therapy retrieved from hypertext transfer protocol: //copperwiki.org. Kazuo Murakami ( 2001 ) Laughter Cuts Health Costs retrieved from hypertext transfer protocol: //www.averagemiracles.org.

COUNTRIES WITH HIGH ADULT AND CHILD MORTALITY RATES Essay

COUNTRIES WITH HIGH ADULT AND CHILD MORTALITY RATES - Essay Example Selection of Angola for this analytical study was based on the fact that, the nation has the necessary resources to improve its healthcare system, yet it is one among several African nations with the highest rates of mortality and morbidity. The country also experiences acute shortage of human resources in the health sector, especially nurses. This research paper attempts to give insight into the current state of Angola’s health system, by considering responsible government institutions, healthcare delivery, nursing education and accreditation, and roles that nurses can play to aid in improvement of the country’s health outcomes. Government Angola is a republic, meaning that its government is chosen by the electorate. The country currently has a stable executive government framework. The president is usually a leader of the coalition or party that gets the highest number of votes in the National Assembly (NA) elections. The president heads the executive branch of govern ment and he or she may serve one or two five-year terms. It is also the president who nominates provincial governors. These governors then elect district administrators for further devolution of resources (UNICEF, 2008). State of Health Angola’s state of health is currently among the worst around the world, as shown by high infant mortality rate at about 154 deaths for every 1,000 newly born babies, and a mortality rate of 260 deaths for every 1,000 kids under the age of five. The country also has a diminished life expectancy of 40 years (USAID, 2010). These shocking statistics are attributable to widespread prevalence of malaria, acute respiratory diseases like pneumonia, diarrheal diseases like cholera, malnutrition and tetanus, coupled with inadequate access to healthcare. The high rate of mortality in Angola is accentuated by the nation’s lack of properly trained healthcare professionals and infrastructure damaged during the civil war. Another significant fact to d enote is the high maternal mortality rate, estimated to be 1,700 for every 100,000 births (WHO, 2010). This exceedingly high proportion can be attributed to prevalence of malaria and hepatitis, among other pregnancy-linked conditions which are left untreated. Angola is also facing several communicable ailments like sleeping sickness, tuberculosis and leprosy. Nonetheless, malaria is the greatest cause of mortality in the country, with approximately 35 percent of reported annual deaths being as a result of this disease (Costa Mendes et al., 2013). Culture and Traditional Medicine In Angola, adoption of traditional medicine and healing practices can be traced back about four millennia. The fundamental assertion that underlies traditional medicine in the country is that, it developed from    experimental observation of the manner in which man reacted to certain environmental triggers. Traditional medicine is no longer extensively practiced in Angola due to adoption of modern medicine and because about 56 percent of the populace lives in urban areas. However, people in rural areas still believe in traditional medicine and many consume purported healing portions (Connor, Averbug & Miralles, 2010). Healthcare System and Delivery Healthcare service delivery in Angola faces acute human resource issues, especially shortage and lack of qualification among care providers. There are also widespread cases

Water Scarcity and Conflict - Prospects for Human Security Essay

Water Scarcity and Conflict - Prospects for Human Security - Essay Example Increasing demand for this important resource is distressing many countries in the globe and a number of avenues are being instituted to avail fresh water to everyone. Water is productive resource to human being considering its diverse use in the society particular in economic and social sector. Water is used to serve different domestic purposes and so is in economic sector where it is used in manufacturing processes, hydropower generation, and agriculture (Smithies, 2011). This clearly manifest that fresh water is a basic human necessity because without it several industrial processes will stall and all life will eventually become extinct. This means that when people feel that their livelihood and survival is threatened by water scarcity it is likely that they will turn hostile owing to fear, desperation and competition to protect the scarce resource. Earth is undoubtedly a water planet but unfortunately, approximately 1% of earth water is available for human use in an easily access ible way in its freshest form from either the lakes or rivers (Arsenault, 2012). Large part of the earth water approximately 97% is in the oceans and seas while the remaining percentage is held in deep underground water table and icecaps. However, unlike other natural resources water is substantially renewed through a natural cycle whereby rain falls from clouds onto the land and into the rivers and finally to the ocean where they evaporate once again and form clouds. At least 44,000 cubic kilometers of water gets on to land annually as the earth’s hydrological system pumps and transfers the water. Geologists estimate that the word boasts of at least 1,700 cubic meters per person, which is the minimum threshold that is required for household, agricultural and industrial use (UNDP, 2006). However, the biggest challenge is the wide disparity in the distribution of this vital resource considering certain countries are endowed with vast water resources while other have less or no ne at all. This difference in availability varies with regions. For instance, countries in Latin America boast of at least 12 times more water per individual compared to those in South Asia. Individuals can understand water scarcity from the dimension of supply and demand equation whereby demand surpasses supply. However, the biggest challenge lies in understanding what is leading to increasing water scarcity and its ultimate consequences. Hydrologists consider 1,000 cubic meters of water per person to be a state of water scarcity and below 500 cubic meters to be absolute scarcity. In most countries around the globe with the exception of perennial arid areas, water has been seen as an unlimited natural resource owing to the seasonal renewal through rainfalls (UNDP, 2006). Because of this reason, human population has continually exploited available water resources with little regard for future costs of overexploitation. People continue to misuse water to the extent that countries wit h adequate water supply owing to consistent rainfall are experiencing high level of scarcity. Most of these countries especially in African continue to battle with drought and crop failure and perennial hunger. It is unfortunate that public view about water security is only focused on scarcity. In other words, people are only concerned about the world running out of water while ignoring an important aspect of water insecurity, which involves mismanagement. Water security revolves around risk and vulnerability. This is evident in societies that have managed to harness the productive

Johannas Kepler Essay Example | Topics and Well Written Essays - 1250 words

Johannas Kepler - Essay Example Kepler's epistemology was profoundly concerned with astronomical practice, with methodological issues, and with the results of their application to the serious problems of late-renaissance astronomy. Kepler not only was able to ask questions in a way that no one had before asked, but he was able to provide answers to those questions that even now are worthy of continued study. From this perspective, Kepler was less the last great cosmologist of the classical tradition that includes Ptolemy and Copernicus; more was he the first cosmologist of the modern tradition. In the middle of the sixteenth century, fourteen centuries after the death of Ptolemy (c. A.D. 100-170), his Almagest still dominated all of astronomy. With the renaissance of interest in the works of the ancients, the relevance of the Ptolemy's great work had not only not diminished, but was on the increase (van Helden, 42). But by the end of the sixteenth century and the beginning of the seventeenth the Ptolemaic system was facing serious challenges. The subsequent revolutionary transformation from the geocentric to the heliocentric worldview has been almost universally attributed to the works of Nicholas Copernicus (1473-1543). Copernican astronomy is best known for the radical proposition that the Earth is in motion about the Sun rather than vice versa. Copernican heliocentrism emerged from a profound dissatisfaction with the fundamental principles upon which Ptolemy had based his system of the heavens. In particular, the Ptolemaic assumption of the punctum equans Copernicus vie wed as contrary to the admissible explanations for the true motions of the planets. The punctum equans, or equant point, is an eccentric point about which the planet is supposed to subtend a uniform angular speed. Historically, published in 1956, Johannes Kepler's first and evidently most influencial astronomical work Mysterium Cosmographicum was the first major treatise after Copernicus' De revolutionibus to argue for heliocentrism (Gingerich, 347). Although Kepler has been defending the theory of Copernicus from the very beginning, with Mysterium Cosmographicum scientist provided a new kind of theory of the planets. His theory of the planets has been classified as new because it was the product of the first explicit and thorough attempt to consistently unify the epistemological structures of the hitherto divergent sciences of astronomy and physics (Koyre, 119). Kepler's objective in Mysterium Cosmographicum was nothing less than the development of a theory of the absolute structur e of the world system. Kepler was certainly not the first to attempt to provide a general cosmographic account of the planets, that is, an account that seeks to explain the proportions of the universe as a whole. Both Ptolemy's and Copernicus' respective theories each maintain not only an ordering of the planetary orbs, but contain estimates of the ratios of their dimensions. But in the theory of Ptolemy these estimates are empirically underdetermined because of the independence of each planetary hypothesis, and in the theory of Copernicus, the estimates are strictly a posteriori consequences of the heliocentric hypothesis and, because of their reliance on Ptolemaic observations and mathematical constructions, no better corroborated

AuditingSelect a company quoted on the UK stock exchange. Obtain, or Case Study

AuditingSelect a company quoted on the UK stock exchange. Obtain, or download a copy of, the company's last annual report c - Case Study Example This report will touch on the key areas of audit risk that have heightened in the audit report for the year ending 30th April 2012. The main sources of information will be the annual report, respective audit procedures and any other relevant sources. Areas of increased risk a) Revenue Stage Couch Group’s revenues are generated from the three main divisions (continuing operations) which include Rail, UK Bus and North America as a number of joint ventures. Revenue is a key area of concern as it is used in assessing the group’s overall growth and performance (Stage Couch Group Annual report 2012). As pointed out in the company’s annual report for the year ending 30th April 2012, the overall performance was as a result of increased sales in all the three divisions. The revenue increased by 7.76 per cent in 2012 from the 2011 financial team. There are times when the management of a company may misstate the revenue with the aim of impressing investors, the top level ma nagers or the board of directors. The group recognizes revenue share amounts payable or receivable in its income statement at the same period in which related revenue is recognized. The revenue obtained from maintenance income and advertising incomes is treated as miscellaneous revenue by the company. The management of the company says that the company had performed well. However, the low percentage increase in revenue from 2011 to 2012 may be an issue of concern. A 7.76 % increase in the total revenue may be an indication of misappropriation and misstatements. This is a reason why the increase in revenue is an area of increased risk. Investor’s motive is to invest in a company that performs well and indicates growth. They get information of a company through the financial statements so as to make investment decisions (Stage Couch Group Annual report 2012). Therefore, if the revenue for instant does not indicate any growth, they will not invest in that particular company. Oth er times human error might occur when recording revenues or revenue may be recorded at the wrong time. This is another reason of concern on revenues. The audit procedure here is for the auditor to have an understanding of the company and the industry in which the entity operates so as to have a better assessment of the auditing procedures outcome. Audit procedures would also include vouching and verification procedures and analytical review of the financial statements. b) Cash When the company has enough cash, it means that its liquidity position is secure. Cash balances and receipts usually affect the profits of a business. Stage Couch Group cash balances decreased to ? 241 in 2012 from ? 358.3 thus this is a key area of concern that calls for scrutiny of internal controls to detect any error or fraud (Stage Couch Group Annual report 2012). The auditor uses analytical procedures as the audit procedure in detecting any fraud. He compares the cash balances with the projected cash and if the balances exceed or fall below the years expectations, tests of detail are performed. Cash is an area of concern because the management might overstate it to cover up on its liquidity position. c) Accrued receivables According to the 2012 financial statement, accrued receivables decreased to ?16.4 million in 2012 from ? 19.4

Contact Issues in Family Law Essay Example | Topics and Well Written Essays - 3750 words

Contact Issues in Family Law - Essay Example The increasing incidence of divorce has created custody battles and problems of access, which have proved to be detrimental to children. Studies conducted by Flouri and Buchanan have revealed that rancor among divorced parents and lack of contact with their father can lead to depression in children, especially girls and in the case of males, the absence of a father can also lead to criminal behavior. According to Matthew Stannard, one of the causes for violent criminal behavior in fatherless boys may be a â€Å"mother’s hostility† towards the father which deprives the child of contact with him, or because the father doesn’t take fatherhood seriously. Bob Geldorf, one of the most vocal activists for the rights of fathers, pointed out that fundamental changes are required in the law and the process in family courts, which tend to favor mothers in the battle for custody of children. The family Court system is based upon adversarial rules of litigation, and acrimonious divorce proceedings can often place the parents as bitter opponents in the Courts and cause child custody hearing to become scenes of power struggles. The family Courts have been ineffective in enforcing court ordered access to fathers, since they are reluctant to separate the children from their mothers and there is a lack of availability of middle ranking punishments and incentives to ensure cooperation from mothers – even when punitive fines and prison terms exist for breaching of contact orders, they may not be imposed in view of the danger of adverse consequential effect upon the child. Family cases take a long time to be processed through the court system, as a result of which fathers are denied access to their children for extended periods.

The Civil War Produced More Radical Changes in America than the Essay

The Civil War Produced More Radical Changes in America than the Revolutionary War - Essay Example Here in this essay, I would discuss that whether the civil war produced more radical changes in America or the Revolutionary war. REVOLUTIONARY WAR: The ideology of John Locke impressed American Colonies and provoked them to fight for their rights. Locke wrote in â€Å"Two Treaties of Government† that it is beyond humanity to rule individuals and rejected the claim of kings and queens of having a divine right to rule masses. Locke infused the spirit of liberalism and democracy. (John Locke, 1821) The main idea of Revolutionary movement was to address the differences that lay within a mother country like religious, traditional and social differences. He stated: â€Å"The natural liberty of man is to be free from any superior power on earth, and not to be under the will or legislative authority of man, but to have only the law of Nature for his rule. The liberty of man in society is to be under no other legislative power but that established by consent in the commonwealth, nor under the dominion of any will, or restraint of any law, but what that legislative shall enact according to the trust put in it.† (John Locke, 1821) Evolutionary War was more than a political agenda and took course during 18th century which initiated in 1763. The seed was sown earlier after the British forces enforced the series of taxes on the American Colonies which was imposed in the name of defense and security cost. American colonies felt the discrimination that was made by British regulatory authorities as British person were not made liable to pay tax. The discrimination enraged American Colonies and in retaliation their Thirteen Colonies in North America collaborated and stood united to form a separate nation which would have no influence or governance from the British Empire. To make their move official, they rejected the rule of Parliament of Britain and together they cast out the royal officials. The colonies demanded for an elected representative in the ruling Brit ish Parliament and within the span of two years, American colonies formed Committees for Correspondence which would direct their own Provincial Congresses in majority of the colonies. The advantage of committees was enormous as it was easy for individuals to share and comment on different issues between British community and American Colonies. With a little more efforts, the provincial congresses proved to be effective and dismissed the parliament and replaced all British ruling bodies. In response to this political setback, British government tried hard to assert pressure and reform authority by dissolving local governments with the help of British troops and to impose rule directly from Royal officials. British troops were confronted by American militia in 1775. George Washington was chosen as commander in chief to guide and lead the army as American Militia lacked in almost every essential skill or training. Washington finely used both army and militia for his strategies to defea t British combat troops. Blacks were promised to be freed if they serve the army and soon blacks in large numbers were recruited in both the armies. Large number of blacks escaped and joined the British Army against Americans. After a constant fight between both nations, the Independence of America was declared on July 4, 1776. The main purpose was to achieve liberty, democracy and equality among the nation which was severely lacking in the British Empire. CIVIL WAR: (Nicolay, 2009) In the middle of 19th Century, Abraham Lincoln was chosen

EU Law Essay Example | Topics and Well Written Essays - 1000 words

EU Law - Essay Example In the same year, she launched claims for consideration of an educational grant in the UK, giving reasons that courses in genetics were not offered in her country Germany. The application was rejected on ground that Ms. Morgan did not meet conditions on paragraph five, clause two that is 5(2) of the Federal Law on encouragement of Education and Training BAfOG. Ms. Morgan was denied grant, because she was not continuing her learning in another member state, studies initially pursued in Germany for at least one year. She had started her’s in the UK and so, failed to satisfy that condition. In the second case, Ms. Bucher began her studies in ergo-therapy in Netherlands, close to the German border. Living with her parents in Bonn, they moved to Duren, where she registered as her permanent residence before traveling to Heerlen for studies. Ms. Butcher applied for an educational grant to pursue training the Netherlands. The application was rejected on condition that Ms. Bucher did not fulfill paragraph 5(1) of the BAfOG. It was alleged that Ms. Bucher established residence on the border to facilitate her training. Reason given for denial was, Ms. Bucher did not satisfy the conditions either on paragraph 5(1) of the BAfOG or those stated on 5(2). Entitlement to an educational grant as member state citizens to both applicants is the factual claim in the two cases that is C-11/06 and C-12/06 Questions referred to the Court of Justice for interpretation were two, the first question common in both cases. Does the rights of movement allocate for citizens in the Union under Articles 17 EC and 18 EC the rights to deter a Member State, in a case like Ms. Morgan’s and Bucher’s, from awarding an education or training grant to its nationals for a course of study in other Member States on ground that the course does not reflect a continuation of studies pursued at an educational institutional in their national

Physical Education and Academic Achievement Research Proposal

Physical Education and Academic Achievement - Research Proposal Example Students shall be divided into two groups: A physical education class and an academic-oriented class. This division shall occur for both 7th and 8th classes which indicate that there shall be four groups. Each group shall be compared from each other thru instruments detailed in later sections. The groups shall be observed weekly and shall be made to undergo a Physical Fitness Test immediately followed by Academic tests. Expected time frame is 3 months. In effect, the data shall provide two results: 1) whether exposure or non-exposure to physical education affects academic performance and 2) how the intensity of physical activity itself affects academic performance Covariant data shall be constructed for fifth categories. First is the family income where students shall be classified into families having $20000, $20001-60000, $60001-75000 and >$75000. These categories are based on National Statistical Socio Demographic profile which attaches corresponding ability to provide for educational materials with the amount of annual income. Second is the child's ethnicity where the participants shall be classified as: a) White, non-Hispanic, b) Black, non-Hispanic, c) Hispanic and d) other. Third is the previous academic background and performance. Fourth is the any additional educational support system specifically the amount of time a mother devotes to educate their children. The last is the amount of physical activity that the student experiences outside of the school. All data for these categories shall be obtained from parents, guardians and the students themselves. Classroom teachers shall be enlisted to produce reports regarding the number of times that students participated in physical education. The reporting process shall be from 0 (never) to the number of times like 3 times per day. Correspondingly, the teachers shall also indicate the total minutes per day that the sample population were engaged in physical education activities. It shall start from 0 with increments of 15 minutes (1-15, 16-30 with the last choice being >60). The data shall be categorized and labelled as low (0-30 minutes per week), medium (30-60 minutes per week) and high (70-300 minutes per week). At the end of every week, the students shall be made to undergo a Physical Fitness Test (PFT) in the morning and an Academics test in the afternoon. The PFT seeks to identify six aspects of fitness namely: 1) body composition, 2) aerobic capacity, 3) trunk strength, 4) abdominal strength, 5) flexibility and 6) upper body strength. These were chosen because it represents the intensity of physical development that the student has experienced. These data shall be compared with previous physical fitness examinations to fully determine the intensity of physical activity in consonance with the data generated from teacher-provided reports. For the academic tests, consultations shall be made with education authorities and other established education researchers regarding the appropriate content to be administered to the students. It shall also be determined whether test content that has been previously applied in other published studies such as that of Carlson et al (2008) can be adapted. In general, the subjects shall include science, mathematics, linguistics and world studies. In summary, we have four sets of data per group: 1) Physical education exposure, 2) Physical activity intensity and condition, 3) Covariates and 4) Academic

Sanlu Group Essay Example for Free

Sanlu Group Essay The entire world was recently disturbed by the extensive scandal involving imported and contaminated milk coming from China. One company, the Sanlu Group, is believed to be at the center of this milk scare, and it is even speculated that the company had knowledge of the scandal before it was reported (Indiatimes, 2008). Sampling of imported milk from the top three Chinese milk companies are already being conducted worldwide, and it is estimated that ten percent of such milk samples are tainted with melamine, a toxic chemical. Several countries already had varying numbers of children affected or dead, resulting from the contamination of the products (Reuters Foundation, 2008). The said toxic chemical is said to be rich in nitrogen, and it makes the protein level appear higher for milk that has been watered down. Some of the observed harmful effects of melamine on humans, particularly children, are kidney stones and worse, death (Reuters Foundation, 2008). This scandal not only has deleterious effects for the business of China. Worse, it has caused death and severe health consequences to children in various countries across the world. The disorder resulting from the deaths and other injuries has now spread such that most, if not all, countries are conducting tests to determine whether their milk has melamine content. Furthermore, there has been a loss of confidence and a growing doubt in the minds of people on the food products coming from China, and this definitely causes riot in the health community, including the experts and the end consumers. References Indiatimes. (2008). Tainted-milk scam: China apologizes to Taiwan. Retrieved September 25, 2008, from http://timesofindia.indiatimes.com/World/Tainted-milk_scam_China_apologizes_to_Taiwan/rssarticleshow/3523852.cms Reuters Foundation. (2008). FACTBOX:Chinas milk scam highlights risks, raises questions. Retrieved September 25, 2008, from http://www.alertnet.org/thenews/newsdesk/PEK72695.htm

Performance of Equipment Maintenance Services in Healthcare

Performance of Equipment Maintenance Services in Healthcare Performance Monitoring in Equipment Maintenance Services checklist Title Abstract Method: Introduction Choosing And Using Key Performance Indicators Benchmarking In Clinical Engineering Audit Summary Discussion And Conclusion Abstract The objective of this literature review is to deliver results to the key performance indicators in monitoring the performance of equipment maintenance services. Method: Medical equipment management, health source and Medline were used and the search was conducted using different keywords such as key performance indicators, equipment maintenance services and performance monitoring equipment maintenance services. Introduction The medical equipment management approach defines the strategies for oversight and interaction of the medical equipment’s used in treatment, diagnosis and treatment of patients. All the related procedures and policies govern event from selection to acquisition, incoming inspection and the medical equipment management. The mission is ensuring that the medical equipment used in patient care is affordable, safe, accurate and available. The scope of this plan is clinical laboratories and different health systems. (McDermott 2009) Performance indicators should be chosen with care, if not individuals tend to respond by optimizing what is being estimated and hence lose focus of the quality. There are two important questions that should be asked concerning any performance indicator. First, can the performance indicator in question lead to perverse incentives and does it have the required potential to induce the desirable changes. Key performance indicators help a company measure progress towards their set objectives. (Kyan et al. 2004) Additionally, key performance indicators help an organization present of service delivery to come up with the course of action. Different key performance indicators differ depending with the exact nature of service delivery and the company’s approach. Choosing And Using Key Performance Indicators The right indicators vary depending on the reason why the management is choosing them. All key performance indicators contain numerous hidden assumptions. For instance, the company can quote is a known guaranteed downtime percentage with the inclusion of the time when the equipment will not be required. However, at times statistical measures can be very hard to interpret, while clinical users do not consider the actual time of action. (Willson et al.2008) On the other hand process indicators appear to change more often than those that have been made to support specific improvement, and monitor the key factors affecting to quality of output. Result measures are more bound to estimate the effectiveness of initiatives to boost the service. Reasons for the poor performance should be thoroughly investigated, for instance, a reduction of 15% in monthly number of the exact routine maintenance logged in by the workers could be caused by alternative external demands or slipping internal stand ards. The steps that need to be taken to improve the services include modifying procedures and services, modifying demand or delivering more services. If an indicator has been modified to make it more strong, then it will be very important to maintain comparison with the old for long enough, to find out whether the changes have had any positive impact. Process targets can be interpreted and set in regard to local circumstances, because the detailed practice commonly varies, on the other hand, outcome indicators are directly comparable between the services when similar definitions are used (McDermott et al. 2009) Cost measures are quite sensitive to what the service chosen omits and includes. Across a typical hospital, the annual maintenance cost per item included varies widely. Detailed research will give the right guidelines on where the reduction of cost will be more effective. At this point, a lifetime strategy to costing can greatly help avoid the situation where technicians spend endless hours repairing the same equipment because the clinical staff lucks the funds required replacing it. A great sense of perspective is required, for instance, so that the total amount of time required to find the right technician can be reduced, this will help theatres to avoid great loses associated with the breakdown of equipment. The clinical engineer will be responsible for balancing urgency and cost and justifying his/her actions to the clinical staff (Gruber et al. 2012) Key performance indicators are reported and monitored to the relevant safety committees in the hospital throughput the year to provide feedback to the efficiency of the medical equipment management plan, the following performance indicators can be quite helpful if well used in a clinic set up. Critical life support performance maintenance completion rate, with a 100% goal and a requirement rationale. Second, the overall performance maintenance completion rate, the goal is 90% and the best practice to report and monitor rationale. Third is the service requests caused by user errors or mishandling, with a 10% or less gal of all the service requests that had not been planned, in this regard, the exact number of chances may be synonymous without consideration of the overall volume of all the service requests received. Mishandling mistakes with the exact requirement will have to be evaluated to find out if the trends exist, with the overall ratio that has been tracked over time providing relevant information for risk reduction. Another performance indicator is the equipment failure rendering harm to staff or the parties, the goal is zero occurrences and the best practice to report and monitor rationale (Swan et al. 2004) The next performance indicator chosen is the hazardous investigations, the main reason for choosing this key indicator was getting the right information, the rationale of choosing the hazardous investigation KPI Is all SMDA recalls, reportable events and medical equipment accident investigations will be instantly reported to the relevant safety committees. The next performance indictor chosen was the performance improvement standards. First, clinical engineering is responsible for identifying performance improvement indicators, based on the priorities that have been identified by users of the medical equipment in question, the relevant department and the environment or safety care committee. The environment or safety committee has the sole responsibility of approving the thresholds and monitors on yearly basis. All performance maintenance indicators are reported after every three months to the safety committee. The information provided is then submitted to the governing body involved via the regular reporting channels. All the elements of performance indicators can be changed upon request based on the administrative input, the institutional experience and regulatory change (Willson et al. 2004) Benchmarking In Clinical Engineering Over the years, there has been a lot of benchmarking activity with the clinical engineering sector. Clinical staff and hospitals are continually finding that there are many issues that are pushing them towards benchmarking. In this sector, we shall look at different methods in which benchmarking in the hospitals in used and the most common measures that are available. These different measures fall into different categories depending with the service they are used to measure. The outlined derivation of benchmarking measures differ between different organizations, and checking into the differences is often vibrant than opting to do a direct comparison. This results into a debate when estimate the cost against other relevant performance measures. In addition, they help guide in making evidence based decisions which integrate the quality with the worth of money. (Willson et al. 2004) In Canada, standards for evaluation and measurement of the best clinical engineering services were introduced back in 1998. To put everything in order, the Canadian biological and medical society created a review to boost the sharing of concepts. Another alternative option is making the use of external consultants to measure the service and advice on the utilization of performance indicators and quality systems to enhance it. Audit This is very important to getting and maintaining the highest quality standards. In its simplest terms, the audit compares the current and the intended practice and immediately reports on the difference. For instance, many follow a person through the maintenance process whilst looking out for any deviation from the right procedures, checking out the records and terms to ensure they have been completed successfully. This strategy is relevant to the internal audits and has the capacity of identifying whether the procedure is working as expected, unfortunately, it does not capture the power of exactly what the audit can achieve. (Willson et al. 2004) As a result, an auditor requires some level of incidence without carrying the responsibility of the area being audited single handedly, this is something that is very hard to achieve in small organizations. If this is done successfully, external audits may bring sufficient benefits mainly if the auditing was conducted by an experienced audi tor from another company. In simpler terms, a simple audit process visits are made up of: Preparation and planning: The auditor agrees to the extent of the audit in advance. Opening meeting where the auditor meets with the management representative to discuss the importance of the audit. Audit: Includes visits to several areas, interviews with the organizations staff and examination of the databases. Closing meeting: The audit meets the management to explain and share their audit findings and confirm the queries, indicating how the issues will be resolved. Audit report: The audit writes a conclusive report clearing outline recommendations for improvement. Once both parties agree to the report, it is signed and passed to the relevant bodies. Follow up: The auditor follows up checks out the corrective actions to see whether they have been completed. Organization auditing can be used to measure how technical and scientific procedures are being followed and whether they will give the right results. This perfect type of audit may be conducted by experienced professional bodies under registered national schemes. For instance, thorough checks between radiotherapy determinants for quality assurance schemes and dose delivery. Basically, it looks at the product, so that they can test a complete system that is where it differs to outline quality control. (Willson et al. 2004) Summary In this report, we have identified many reasons why a company should monitor its performance; we have also discussed the importance of integrating monitoring in a top-notch management system. We have vividly described the design of key performance indicators and looked at how they can be implemented in medical equipment management. (We have also outlined the pitfalls associated with developing and interpreting performance indicators and considered their utilization in practice. We have also reviewed how benchmarking can assist organizations enhance their performance. Finally, we have considered how audits should be strategized, what happens during the audit and how different groups of organizations can combine efforts and assist each other with benchmarking and mutual audit activities. (Grubel et al.2008) Discussion And Conclusion One important thing to understand is the fact that key performance indicators are not performance targets. They are put in place as monitoring facilities with the idea of moving towards the direction of the successful implementation of the procedures, policies and process. Performance indicators are categorized into two distinct groups, namely, quantitate and qualitative. (McDermott et al. 2009)There are two things that must be identified in order to use KPIs effectively; these include the points in procedures or process through which the data is gathered to support the equipment monitoring. Secondly, the locations in service where the data gathered should be presented as important information for quality management. KPI’s are important because they enable facilities to have systems in place for better management of medical equipment and devices. A few of the reasons why key performance indicators are used include more complicated, enhanced technical preventative maintenance, regularly needs consistent quality assurance and specialized user training. (McDermott et al. 2009) References McDermott, R. (2009) Key Performance Indicators Medical Devices/ Equipment Management.’ A Case Studies Of Equipment Management. London: Routledge Willson, K., Tabakov, S., Ison, K., et al 2013, â€Å"Medical Equipment Management.† [Online] 1, (1) 274-280. Available from http://www.openbooke.com/ebook/medical-equipment-management.html> [accesed on 30th April 2015] Gruber, S (2012) Exploring Analytical Solutions For Healthcare Improvement [Online]. Healthcare Analytics, New York. Available at: http://healthcareanalytics.info/2012/02/is-it-a-metric-or-a-key-performance-indicator-kpi/#.VUJEvlFMK_I [Accessed on 30th April 2015]

Learning about spelling strategy

Learning about spelling strategy Introduction Spelling strategies in the primary curriculum have consistently provoked criticism and debate amongst teachers, Ofsted and the Government.[1] Standards continue to decline highlighting that the present strategy is failing.[2] A central criticism is that teachers do not have the necessary knowledge of the relationship between word structure and spelling, and rely on techniques they learnt at school, specifically the use of memorized spelling tests. (Spear-Swerling, Brucker Alfano 2005). The major concerns are that this approach hinders the teachers ability to identify the correct spelling instructional level of individual pupils, and produces a trend where pupils who score high in tests will subsequently misspell the same words during written exercises; this is the case at my chosen school.[3] The Key Stage 2 curriculum is similarly criticized both at the school and in general, because it fails to consistently describe how word lists are selected or base selection on current linguistic spelling principles and developmental research. (Scott 2007). This may or may not be developmentally appropriate for the class as a whole or for individual pupils, especially in the area of creative writing (Stone et al. 2005 p662). It will be the purpose of this study to analyse and evaluate current theories and case studies for teaching spelling and writing at Key Stage 2 that could be utilized by the school. There are three dominant strands to teaching that will be investigated here, Developmental Stage Theory, Incidental Inventive Spelling theory and the Multi-sensory approach.[4] Spelling Strategies: An Investigation Developmental Stage Theory identifies 5 stages of spelling development; Prephonetic, Phonetic, Patterns with Words, Syllable Juncture and Meaning-Derivation. (Henderson in Bear et al. 2004).[5] Studies have discovered that pupils who experience significant difficulty with spelling will still follow the same developmental course as other pupils, but at a slower pace. (Worthy Invernizzi 1990). The approach therefore promotes a move away from memorization skills to supporting a pupils natural developing awareness of language with practice in wide reading and writing, and be based on the pupils developmental level as opposed to unitary placement in the grade level based spelling book. (Schlagel 2002 p.47). A developmental spelling analysis (DSA) such as the Qualitative Inventory of Word Knowledge (QIWK) technique is used to initially identify and analyse a pupils current stage through scoring, inventive spellings and error patterns relating to writing and word sorting activities. Word sorts of increasingly difficult levels using words from the 5 DTS stages are used because they provide an interactive means of helping pupils understand spelling concepts on an increasingly abstract level (Bear et al. 2004). Subsequent teaching, spelling and writing exercises are tailored to both stage and development strategies by focusing on fewer words in word sorts at a time, teaching spelling patterns and providing numerous practice writing sessions and self/peer review strategies.[6] Together they allow for a systematic observation of higher-level processes and improve metacognitive abilities. (Seifert-Kessell in Fresch 2000). This approach moves away from the reliance of pupil memorization of words that is said to produce effective performance in spelling tests but poor performance in writing, and over time, as pupils forget the words they have memorized. (Seifert-Kessell in Fresch 2000) The case study Beyond Memorisation, Lists and Trial Tests by Hillal Scharer is an excellent example of the DTS process. Using QIWK teachers were able to expand their understanding of KS1 KS2 equivalent pupils as spellers. One teacher discovered that her class ability ranged from levels 2-8 on the QIWK scale, another commented I need to get better at recognizing what levels they are at. It only makes sense that if kids are at different reading levels, they will be at different levels in their spelling. I dont know why I didnt recognize this before. (Hilal Scharer 1993). The strategy does not just allow for effective grouping and targeted learning at the instructional level, it also provides a detailed method for qualitative data analysis in pupil errors over time. One teacher documented a concern that score levels had not improved between May and January, however, when the error data was analysed using the QIWK method she discovered that over half were moving from the letter name stage to the within-word stagethis is so much more pleasant, you can see growth, what more could you ask for? (Hillal Scharer 1993). A third and perhaps the most significant development was that teachers noticed changes in spelling errors in written assignments. Rather than circling errors they cross-referenced with a QIWK analysis and systematically documented them. This inferred weekly selections of word lists that were chosen from misspelled written work rather than the curriculum textbooks. This facilitated mini-spelling lessons linked to written work through observed errors and provided an environment for coaching in self-editing and peer editing strategies using QIWK word sorts as a base. Peer marking and discussions have, themselves, provided an additional strategy here that has been documented to benefit pupils learning. By grouping pupils of similar spelling ability they learn at the same pace, feel empowered and by judging the work of others, students gain insight into their own performance (and language)peer and self-assessment help pupils develop the ability to make judgments, a necessary skills for le arning.'( Brown, Rust Gibbs 1994). It will be seen throughout this chapter that peer work and assessment strategies lend themselves to the majority of spelling strategies discussed, this will be discussed in more depth in the conclusion. The headteacher summarized; theres been a move away from memorization activities to active tasks such as creative writing, word hunts and word study notebooks (this) extends and records development of word knowledge. (Hillal Scharer 1993). All the teachers involved in the study stated they would continue but required support strategies from the school to implement, this a recurring theme for all researched case studies and will be therefore be discussed in the conclusion. A subsequent developmental case study entitled Using Think-Alouds During Word Sorts (Fresch 2000) encouraged KS2 level pupils to put your brain in your throat and tell us what you are thinkingkeep talking. The study was determined to open a window into the decision-making process because information stored in the short-term memory is vocalized and caters for systematic observations of higher-level processes. (Olson, Duffy Mack in Fresch 2000). The results showed that think-alouds enable pupils to demonstrate the extent to which they rely on auditory or visual informationstudents develop knowledge about language through active engagement. (Fresch 2000). [7] This in turn can be incorporated into the strategies pupils use while writing; rather than rely on writing and proof reading, the pupils can incorporate a vocal strategy linked to their experience of vocalizing words during DST word sort exercises. While Stage Theory provides a basic template for describing student growth in spelling and writing it is criticized for a repeated emphasis of placing pupils in concrete groups with the assumption pupils progress sequentially without moving back and forth when they encounter unfamiliar words. (Scott 2007). Studies by Siegler (1995) and Varnhagen (1997) have identified an Overlapping Wave Theory that incorporate stage development but allow for fluid movement between stages as they develop. This theory believes pupils possess and are able to use knowledge of phonology, orthography and morphology from an early age, but rely more strongly on strategies at different points in time. (Kwong Varnhagen 2005). Varnhagens case study examined pupil spelling for a KS 1-2 equivalent and identified the same strategies throughout.[8] Their conclusion was that spelling progressed from errors representing the phonetic stage directly to correct spelling. (Scott 2007). The authors themselves are unsure of how this would compliment writing strategies but identify a link to the two strategies that would allow for a better understanding of spelling stage development that would influence spelling strategies as a whole. (Kwong Varnhagen 2005 p.154). In opposition to DST is the Incidental Inventive Spelling approach developed by Montessori (1964) and Chomsky (1979). They observed that children write from an early age and in some cases before they begin to read. They inferred that an invented spelling approach to writing benefits learning because children learn best if they construct a system of their own rather than having it handed to them by an adult.'(Chomsky in Metasala Ehri 1998 p.300). Treimann (1993) echoed Chomsky and Montessori by conducting a year long study where pupils used invented spelling in their writing, then recopying it with standard spelling and finally using for reading practice. It was discovered that the pupils spelling and writing both improved. (Treimann in Metasala Ehri 1998). In a case study by Clarke (1988) pupils at an early KS2 level using inventive spelling out performed fellow pupils in two separate spelling tests, one involving low-frequency words. These results suggest encouraging children to invent spelling while engaged in creative writing helps them to appreciate language comprehension. (Clarke in Metasala Ehri 1998 p.305). Ehri continues to argue that it does not hurt children to misspell words and they do not become locked into misspelling behaviour. An additional discovery was that pupils often do not proof read their own writing and even when they do it takes multiple readings to learn its spelling. By using inventive spelling techniques the inventive group correctly spelled a larger variety of words than the control group. (Metasala Ehri 1998 p.305). Further studies by Ehri, Gibbs and Underwood (1988) and Bradley and King (1992) discovered that pupils beginning Key Stage 2 who were exposed to inventive spelling techniques were more accura te than their counterparts. (Metasala Ehri 1998). Although pupils in these studies were beginning a Key Stage 2 level of education the strength of the study focuses on the ability of pupils to maintain ownership of their creative writing. The teacher remains a facilitator rather than a director. Read (1986) believes writing is part of a childs play with language and the specific activities must grow out of a childs interestshe is likely to direct herself rather than march to an adult drummer. (Read 1986 p.125). The inventive studies have highlighted two areas of interest, firstly is the level of play pupils maintain through writing which could lead to better performance. A study by Gerritz in Read confirms that there was a distinct improvement in pupils writing ability. They were clearly at ease and eager to write. They didnt show any more bad spelling habits than had been experienced throughout years of teaching. (Gerritz in Read 1986 p.125). An enjoyment of writing is perhaps viewed as secondary to spelling performance in the KS 2 strategy and there could be a link between poor spelling performance in writing and the rigidity of spelling strategies. Secondly, the studies have highlighted the in-ability of pupils at this level to identify spelling mistakes in writing. A possible link could be made to the peer-support strategies outlined in the DST studies where-by pupils creatively write first and then, together in QIWK determined groups, analyse the mistakes. There is a third approach relating to a learning styles strategy. Though a combination of neurology, Gardners multiple intelligence and subsequent learning styles theories there are numerous teaching strategies that focus on multi-sensory learning techniques that can build on the traditional spelling lessons. Using neurological evidence Ott (2007) suggests a distinction between dominant left and right brain learning styles. Left brain learners could focus on speech and language through learning word patterns through sound and rhyme, using mnemonics in analysis, logic and language skills, counting syllables and using word derivatives.[9] Right brain learners would focus on visual and spatial skills such as clapping to count syllables, using colour when they identify words, using a computer keyboard and graphic packages, and using mnemonics with illustrations.[10] Gardners theory of multiple intelligences expounds the techniques to include three dominant learning styles that can be incorporated into the classroom.[11] Visual learners could benefit from learning to spell through images, diagrams, mindmaps, media and spelling through analogy and word patterns. The traditional Fernald Method of pronunciation, identification, the tracing of difficult spellings, and writing from memory would especially suite these types of learners. (Ott 2007). Auditory learners could benefit from listening, song, poem, music, rhythm and oral testing. This directly relates to The Simultaneous Oral Spelling (SOS) method that involves pupils sounding out letters, whilst an other pupil asks them to give the letter names as he/she spells the word. Although a basic phonographic technique there is potential for auditory learners to benefit. (Westwood 2005). There is an opportunity to combine with the ARROW method (Aural-Read-Response-Aural-Written). The pupil listens to a recording of single words while simultaneously reading the same words. Oral and written responses via testing allow for a multi-sensory approach to learning words that enhance the traditional memorization technique with a better-suited learning style. (Westwood 2005). Kinesthetic learners could utilise note-taking and physical activities such as model building and play to further enhance the learning experience. (Ott 2007). Although there is a lack of definite case studies relat ing these methods to the relationship of spelling and writing, they do provide a framework for multi-sensory learning that have the potential to be incorporated into the other methods discussed. Pupils (and teachers) could benefit from the awareness of their learning styles and the multi-faceted approaches to learning offered here. The Directed Spelling Thinking Activity (DSTA) developed by Dr Zutell (1989-1991) provides a detailed lesson format utilizing multi-sensory techniques and a process-orientated cycle of instruction that especially suits language learning. (Zutell 1996). This strategy is aimed at systematically connecting to the writing process with a child-centered, active approach to learning.'(Zutell 1996). An initial pretest with contrasting words is given, followed by a group discussion focusing on strategic problem-solving activities. The next day a word sort is initiated that aids pupils to discover the relationships between contrasting word patterns. Throughout the week pupils make connections to their own experiences and take greater control of their learning as they hunt for words, sort words with partners and individually, and use a pupil-chosen selection of practice written activities centered upon identifying patterns and relationships. (Zutell 1996). Word sorts are again utilized providing a link to the DTS strategy. In this case they are based on teacher and student selected single words and multiple sorts of semantic and orthographic definitions. To enhance learning they are sorted both visually and blind, where decisions are made after each word is said, but before it is seen. They are also initiated through group, partner and individual practices to facilitate pupil relationships. The benefits stated here are that pupils notice important features of words being studied, and it can contribute significantly to proofreading abilities. (Zutell Compton 1993). Zutell Compton go to great lengths to describe the positives of word sorting activities. To summarise, they identify the manipulative strengths of movement and rearrangement, the ability to respond to emergent patterns, to facilitate peer support and learning, identify conceptual categories and word memberships and to move beyond individual pronunciation, pattern and meanin g to the interconnectedness of words. Once accuracy is established they can sort on their own and speed sort to ensure internalized, automatic control. (Zutell Compton 1993). Word hunting activities are also identified as effective in creating a sense of ownership in decision-making and to recognize the relevance of what is being studied to their own reading and writing. It is documented to aid the individualization of word lists from the pupils own writing and to the instructional level of the pupil that once more forms a link to the DTS method. (Zutell 2005). Other strategies advised are Flip Folders for independent spelling strategies, specifically the Look-Say-Cover-See strategy discussed earlier in relation to multi-sensory learning. Word Study Notebooks are identified as a writing alternative to the traditional Word Journal because they are conceptually challengingpupils enter words by patterns, such as ch words or vowel-consonant-silent e words. New words and pages are added as new patterns are studies. (Zutell 2005). Games, and specifically board games (i.e. Scrabble), are determined to keep interest high and allow for pupils of all spelling ranges to compete against each other on an equal footing. This provides an anti-thesis to the DTS theory and creates a space for settings and grades to be negotiated in favour of a whole class approach that could build confidence and motivate peer-support. An additional benefit is that pupils must check the accuracy of each others spelling which creates an opportunity for higher learning through an active and fun setting. (Zutell 2005). A final weekly test provides information for both the teacher and for self-evaluation, serves as a guide for journal building, and leads to choices of words for future studies. (Zutell 1996). The benefit of the entire strategy is that it is a child-centered, active, multi-sensored and personalized yet peer-supported strategy that benefits spelling, reading and writing. (Zutell 2005).[12] In addition Zutell claims that this strategy greatly enhances Vygotskys understandings of social engagement by facilitating learning through creative collaboration and learning, mutual appropriation and the enhancement of learning through the zone of proximinal development.'(Zutell 2005). This could be said to be true for any of the group-orientated strategies here pointing to a belief that rote memorization should be exchanged for a creative group approach that facilitates both ownership and peer supporting strategies, especially in creative writing exercises. Conclusion: Considerations for curriculum implementation Any change to teaching practices will have an impact on a myriad of sources. Teachers and subject coordinators will face the challenge of additional training and the procurement of new resources, pupils will require greater initial scaffolding and parents will require educating themselves of the new approach and there may be resistance. This combined effort is traditionally perceived by many teachers as too expensive and time consuming. There are, however, documented strategies that can work. INSET opportunities provide staff with the opportunity to develop new skills and focused teamwork. The subject coordinator can simultaneously create new teaching strategies. Together they can navigate the criticisms that have been documented in the introduction by focusing on learning language structure, perhaps even through the same active techniques as their pupils as they construct the scheme-of-work. During research for this study there were numerous websites identified that provided free lesson-plans and schemes-of-work relating to all methods discussed here, especially the DTS and DSTA. The classroom resources required for creative writing exercises, word sorts, games, folders and word charts, could also be created by the pupils themselves, facilitating coordinated teamwork between Art and English departments. This would allow for an active approach to learning for the pupils and increase a sense of ownership. It also provides a space for simultaneous scaffolding and creative learning across the curriculum, providing a more whole-school approach to spelling in general and the language arts as a whole. The use of free resources and pupil created teaching aids can, therefore, successfully navigate any budgetary requirements. Included in Appendix D is an example of a marking rubric that was designed by a spelling teacher during the move away from memorized spelling tests. She admits the creation of a new rubric was time-consuming but her response to the effort is positive, inspiring and particularly effective in creative writing exercises. (Loeffler 2009). This highlights that committed teachers cannot only achieve success but that there is support available via the Internet. Also included in Appendix E are teacher/parent responses to new marking rubrics and the shift to the DTS method during the case study Beyond Memorisation. The case study exemplifies and clarifies how concerns by both parties were successfully navigated with positive results. There is a particular focus on the impact of a move from traditional weekly grading scores given to parents to a more detailed progressive report that is produced through a combination of DTS and writing strategies. What all of these strategies have discovered is that there are numerous alternatives to the traditionally memorization technique. The DTS, DSTA and Incidental Writing strategies have especially identified working practices that aid the pupil in correct spelling during creative writing exercises. Throughout this research it has become apparent that my chosen school is not an isolated case in the difficulty of producing correct spelling in both tests and creative writing. It is a nationwide problem that clearly identifies that current spelling strategies are not sufficient and that there is a need for more active, creative, multi-sensory teaching techniques and practices within the KS2 curriculum. There is no technique that has been identified as superior, however, throughout this study there were numerous instances where strategies overlap and compensate for each other. It is clear that used together strategically they can enhance both a pupils spelling in all areas and enhance the cr eative writing experience. The additional use of peer-support structures provide a chance for a move away from grading and sets to a whole-class teamwork based learning experience. References Bear, D. Invernizzi, M. Templeton, S. Johnston, F. (2004) Words Their Way: Word Study for Phonics, Vocabulary and Spelling Instruction: New Jersey: Pearson Education Brown, S., Rust, C. and Gibbs, G. (1994) Involving students in the assessment process, in Strategies for Diversifying Assessments in Higher Education: Oxford: Oxford Centre for Staff Development Claire, J. (2004) 200,000 pupils cannot read at seven. @ http://www.telegraph.co.uk/news/uknews/3304750/200000-pupils-cannot-read-at-seven.html Clark, L. (2009) Why Childrens Spelling is Going Downhill @ http://www.dailymail.co.uk/news/article-98156/Why-childrens-spelling-going-downhill.html Fresch, M. ((2000/2001) Using think-alouds to analyze decision making during spelling word sorts: Reading Online, 4(6) @ http://www.readingonline.org/articles/art_index.asp?HREF=/articles/fresch/index.html Hillal, G. Scharer, P. (1993) Beyond Memorisation, Lists and Trial Tests: Exploring the Influence of Teacher Knowledge of Developmental Spelling on Pedagogical Decisions. @ http://www.eric.ed.gov/ERICWebPortal/custom/portlets/recordDetails/detailmini.jsp?_nfpb=true_ERICExtSearch_SearchValue_0=ED364870ERICExtSearch_SearchType_0=noaccno=ED364870 Hinds, D. (2004) SATS thrown back over Hadrians wall @ http://www.tes.co.uk/article.aspx?storycode=2054617 Kwong, T. Varnhagen, C. (2005) Strategy Development and Learning to Spell New Words: Developmental Psychology No.41 pp.148-159 @ literacyencyclopedia.ca/index.php?fa=items.show228 Loeffler, K. (2009) No More Friday Spelling Tests: Council for Exceptional Children @ www.teachingld.org/pdf/teaching_how-tos/spelling_tests.pdf Metsala, J. Ehri, L. (1998) Word Recognition in Literacy: Philadelphia: Lawrence Eribaum Ott,P. (2007) How to Manage Spelling Successfully: London: Routledge Read, C. (1986) Childrens Creative Spelling: London: Routledge Schlagel, R.C. (2002) Classroom Spelling Instruction: History, research and Practice: Reading, Research and Instruction Vol.1 Issue 42 pp.44-57 Scott, C. (2000) Principles and Methods of Spelling Instruction: Topics in Language Disorders Vol.3 Issue 20 pp.66-82 Scott, R. (2007) Spelling research: Classroom Implications: Encyclopedia of Language and Literacy Development @ http://literacyencyclopedia.ca/index.php?fa=items.showtopicId=230 Smith, M. (2008) Howard Gardner and Multiple Intelligences @ http://www.infed.org/thinkers/gardner.htm Spear-Swelling, L. Brucker, P. Alfano, M. (2005) Teachers literacy-related knowledge about English word structure: Annals of Dyslexia Vol.53 pp72-103 @ http://www.southernct.edu/publications/facbib/S/spear-swerling.htm Stone, C. Silliman, E. Ehren, B. Apel, K. (2005) The Handbook of Language and Literacy: Development and Disorders: Guilford: Guilford Press Templeton, S. Morris, D. (1999) Questions Teachers Ask About Spelling: Reading Research Quarterly Vol.34, No.1 pp.102-112 Westwood, P. (2005) Spelling: Approaches to Teaching and Assessment: Camberwell : ACER Worthy, M. Invernizzi, J. (1990) Spelling Errors of Normal and Disabled Students on the Achievement Levels One Through Four: Instructional Implications: Annals of Dyslexia Issue 40 pp.138-151: Springer Science Business Media Zutell, J. (1996) The Directed Spelling Thinking Activity: Providing an Effective Balance in Word Study Instruction: The Reading Teacher Vol.2 Issue 50 pp.98-108 @ http://www.reading.org/General/Publications/Journals/rt.aspx?mode=redirect Zutell, J. (2005) A Student-Active Learning Approach to Spelling Instruction @ http://www.zaner-bloser.com/educator/products/spelling/index.aspx?id=4820view=article Zutell, J. C. Compton. (1993) Learning to spell in the elementary grades: The knowledge base for effective teaching Paper presented at the annual meeting of the International Reading Association, San Antonio, TX. @ journals.cambridge.org/production/action/cjoGetFulltext?fulltextid [1] David Bell, chief inspector of Ofsted was interviewed by The Telegraph in 2004 and stated the governments programme for literacy teaching at primary level is confused.many teachers are given virtually no training in teaching children how to spell. (Claire 2004). [2] A 2002 review of Key Stage 2 statistics stated accuracy in spelling has declined. (Driscoll in Hinds 2004). A 2009 review of national tests stated the ability of children to spell has declined. Pupils aged between 11-14 made more spelling errors than they did in 2000, four years into a scheme to ensure primary pupils have daily literacy hour lessons among 7 year olds spelling tests improved slightly even though heads complained the spelling tests were too hard. (Daily Mail 2009) [3] The school is still reliant on spelling lessons characterized by the use of Basel published weekly lists of words, written exercises focusing on menorisation and two weekly tests at the beginning and end of each week. [4] Developmental stage theory recommends spelling be taught systematically in relation to individual development. Instruction is based on identified student needs as they progress through the developmental stages. The incidental inventive writing approach, which advocates teaching spelling as the need arises in student writing throughout the school day. The multi-sensory approach focuses on the theory of learning styles and multiple intelligences to identify the best strategy to teach individual pupils. (Schlagel 2002) [5] Phonetic is the true beginning of alphabetic writing and reflects some understanding of phoneme-grapheme correspondences), Patterns Within Words (deeper understanding of orthography (the visual written form). Syllable Juncture (the abstract conceptualization of the spelling system, focuses on the place within words where syllables meet, and an understanding of spelling changes when inflectional endings are added to root/base words (plurals, past tense marker, present progressive verb endings, other spelling concepts that are grasped at this stage include possessive forms and contractions). Meaning-Derivation (concentrates on the morphological connections (coding words by the parts of words that signal meaning and grammar) in English orthography. Students learn that in written English, words that are related in meaning (sharing a common root) are usually spelled similarly, even if they are pronounced differently. (Scott 2007). Please see Appendix B for a complete explanation of the 5 stages. [6] QIWK itself consists of eight progressively complex stages of word lists and spelling patterns relating to DST. Word lists and word sorts match the developmental stage with later stages (Syllable Juncture Meaning Derivative stages) involving morphological principles such as base and derived forms and word origins. [7] This aspect of think-aloud strategies form an interesting link to the multi-sensory approach that will be explored later in the chapter. (See Appendix C for detailed examples of word sorts and pupil responses.) [8] The study analyzed childrens spelling of silent -e long vowels and different types of -ed past tense words for signs of a strong developmental progression of qualitatively distinct stages from semi phonetic to phonetic to transitional to correct spelling over time. (Scott 2007). [9] Ott offers the following examples; sounding word patterns such as the ight sequence in light, bright, fright and might. Mnemonics such as our dear mother uses great rigour and vigour for every Endeavour. Syllable counting such as /mag/ni/fi/cent and /won/der/ful. Word derivations such as signature derived from sign or automatic derived from auto. (Ott 2007 p.106) [10] Ott explains the use of a computer keyboard will aid learning because they can utilise motor memory to remember finger placement and visual memory to memorise patterns. Graphics packages will help remember pictures and associate letter patterns with pictures. (Ott 2007 p.106). [11] Gardners multiple intelligence theory identifies 7 intelligence types; linguistic, logical-mathematical, musical, bodily-kinesthetic, spatial, interpersonal and intrapersonal. (Smith 2008) [12] Case Study results were difficult to obtain but Zutells work has been endorsed by The International Reading Association, The National Council of Teachers of English and The Language Arts and Reading Company. This highlights the perceived effectiveness of his approach and justifies inclusion here.